A qualitative evaluation of the process of creating and implementing an interprofessional care pathway for patients treated with oral anticancer drugs. (December 2022)

• Record Type: Journal Article
• Authors: Kinnaer, Lise-Marie; Van de Vyver, Marlies; Kenis, Ilyse; Decoene, Elsie; Foulon, Veerle; Van Hecke, Ann
• Is Part Of: European journal of oncology nursing. Volume 61(2022)
• Publication Date: 2022-12
• Subjects: Care pathway -- Complex intervention -- Implementation -- Barriers and facilitators -- Oral anticancer drugs -- Process evaluation -- Interprofessional care -- Oncology nursing -- Seamless care; Cancer -- Nursing -- Periodicals; Cancer -- Research -- Periodicals; Oncology -- Periodicals; Oncology Nursing -- Periodicals; Neoplasms -- nursing -- Periodicals; Cancer -- Soins infirmiers -- Périodiques; Cancer -- Recherche -- Périodiques; Cancérologie -- Périodiques; Verpleegkunde; Kanker; Cancer -- Nursing; Cancer -- Research; Oncology; Electronic journals; Periodicals; Electronic journals; 616.9940231
• DOI: 10.1016/j.ejon.2022.102218
• Languages: English
• ISSNs: 1462-3889

Abstract

Abstract: Purpose: To investigate factors affecting the co-creation and implementation of care pathways for patients treated with oral anticancer drugs. Methods: An explorative qualitative process evaluation was performed at four Belgian hospitals, co-creating and implementing a care pathway for patients on oral anticancer drugs. Semistructured interviews and focus groups were performed by a) local coordinators leading an interprofessional project team during the co-creation and implementation stage, b) external implementation coaches, and c) teams of healthcare professionals with a role in the care pathway. In total, 47 stakeholders were interviewed. Interviews were audio-taped, transcribed verbatim, and analyzed thematically. Results: We found four factors affecting co-creation and implementation of care pathways for patients on oral anticancer drugs. Developing an adequate supporting context using motivated interprofessional project teams of clinical and management staff led by competent coordinators is one important facilitator. Leadership of local coordinators and oncologists is crucial for progressing the co-creation. Other factors included the complexity of the oral anticancer drug intervention, the interprofessional character of the care pathway, and involving primary care. External coaching during co-creation proved an important facilitator. Conclusions: Prior investigation of willingness and motivation to change in clinical and management staff, competent coordinators, and leadership of oncologists are needed. In addition, external support determines the success of co-creating and implementing care pathways for patients on oral anticancer drugs. Highlights: The complexity of co-creating and implementing a seamless care pathway for patients treated with oral anticancer drugs: a qualitative process-evaluation – highlights. Oncology centers struggle to organize seamless care for patients on oral anticancer drugs (OACD) Co-creating and implementing care pathways can be a strategy but is a challenging process A supporting context and leadership in coordinators and oncologists facilitates co-creation Aligning work processes in interprofessional teams and involving primary care was difficult Tailoring care pathways and external coaching determine the success of co-creation